The purpose of this IM is:

To reduce the morbidity and mortality of refugees and migrants immigrants in Kenya.

Strengthen and scale up prevention, care and treatment among HIV positive refugees and migratory populations in Kenya, including urban refugees in Nairobi.

Provide a comprehensive package of prevention services to populations at increased risk of HIV/MARPs including CSWs, out of school youth, miraa traders/users, and migratory merchants within the refugee populations.

Provide other combination prevention services including STI screening and treatment and ART.

Provide care and treatment services specifically for this marginalized but highly migratory population.

Establish community outreach campaigns that promote knowledge of HIV status and provide education for other health seeking behaviors specifically for those refugees identified for re-settlement to the United States of America and linkage to programs once in the United States.

Establish syndromic surveillance systems to enable early response and detection to communicable diseases of public health significance in these populations.

TBD will support care and support services for 200 HIV-infected adults at Dadaab and Kakuma refugee camp in North Eastern and Rift valley Province, Kenya and will target both refugees and the local population who access care in the refugee based clinics. TBD represents a follow-on for care and support activities (HBHC) currently provided by International Rescue committee and UNHCR.

Sentinel surveillance activities in 2005 reported a 1.4% HIV sero-prevalence among ANC clinic attendees, and 1.7% among STI patients, indicating a generalized epidemic and providing an estimate of 2,300 HIV-infected refugees.

Dadaab, which was established in 1991, consists of three settlements (Ifo, Hagadera and Dagahare), and hosts 140,000 Somali refugees and 20,000 Kenyan Somalis. Each camp has a hospital and three satellite health centers. Kakuma Refugee hosts 55,995 refugees of nine different nationalities out of which 5,090 are local. In Kakuma, the IRC directly implements HIV interventions at Kakuma Refugee camp serving mostly the refugee population while implementing HIV activities for the host population through partnership with Kakuma Mission Hospital.

TBD will identify mechanisms that will address client retention and referrals including the use of outreach and bidirectional referral systems. TBD will create and identify linkages with other HIV program sites and non HIV program services for specific services within its jurisdiction.

TBD will use accredited methods of program monitoring and evaluation, monitoring quality of care and support services to inform the care and support program.

TBD will expand care programs by providing technical support, training staff, supporting staff salaries, conducting laboratory evaluation, and providing adherence counseling and monitoring.

TBD) will support expanded treatment services to 2000 orphans and vulnerable children (OVC) and train 200 caregivers at the Dadaab and Kakuma Refugee Camps in North Eastern Province and Rift Valley Provinces of Kenya respectively, targeting both refugees and the local population.

Sentinel surveillance activities in 2005 reported a 1.4% HIV seroprevalence among ANC clinic attendees, 1.7% among STI patients, indicating a generalized epidemic and providing estimates of 2300 HIV-infected refugees.

TBD will build on established PEPFAR supported treatment activities currently being provided by among others , CARE, National Council of Churches of Kenya, GTZ, International Rescue Committee and UNHCR for with the OVC at the refugee camps hospitals and health centers.

Dadaab refugee camp consists of three settlements (Ifo, Hagadera and Dagahare), and hosts 140,000 Somali refugees and 20,000 Kenyan Somali. Each camp has a hospital and three satellite health centers. Kakuma Refugee hosts 55,995 refugees of nine different nationalities out of which 5,090 are local.

OVC will receive a package of services as per the PEPFAR and other UN guidelines, complementary to others services that are already provided through the overall UNHCR refugee framework. An important element in this program is strengthening HIV prevention education among OVC to equip them with life skills that would reduce their vulnerability to the risk of HIV infection. Caregivers will be trained to strengthen the family support system and strong linkages will be established between PLWHAs, HIV-infected children and health care services, including ensuring that children and their parents or caregivers and other family members affected access appropriate care and treatment. The scope of the current programs will be expanded to ensure that they provide a package of essential services that qualify as primary direct support. All programs will work in close collaboration with the District Children's Department and will follow guidelines provided by the parent ministry, alongside PEPFAR and UNHCR guidelines.

There will also be recruitment of staff both incentive and national to support and follow up OVC's. These include incentive counselors in the entire camps pediatric counselor, HIV/AIDS and gender project officers and HIV/AIDS and behavior change

TBD will ensure that all activities will link to Abstinence/ Be Faithful, condoms and other prevention UNHCR and Counseling and Testing UNHCR, ARV services, Basic Health Care and Support. The various implementing partners in the refugee camps will work collaboratively under TBD guidance to offer appropriate interventions to OVC and their caregivers.

TBD will expand OVC programs by providing technical support, supporting staff salaries and training staff.TBD will offer community based support activities to OVC and their care givers, unaccompanied minors, older OVC, widows and widowers, HIV/AIDS affected families and people living with HIV/AIDS. The outcomes of these activities will be monitored and evaluated.

TBD will support expanded treatment services to 100 HIV-infected individuals at Dadaab and Kakuma Refugee Camps in North Eastern Province and Rift Valley Provinces of Kenya respectively, targeting both refugees and the local population.

Sentinel surveillance activities in 2005 reported a 1.4% HIV seroprevalence among ANC clinic attendees, 1.7% among STI patients, indicating a generalized epidemic and providing estimates of 2300 HIV-infected refugees.

TBD will build on established PEPFAR supported treatment activities currently being provided by the International Rescue Committee and UNHCR for people with HIV at the refugee camps hospitals and health centers.

Dadaab refugee camp consists of three settlements (Ifo, Hagadera and Dagahare), and hosts 140,000 Somali refugees and 20,000 Kenyan Somali. Each camp has a hospital and three satellite health centers. Kakuma Refugee hosts 55,995 refugees of nine different nationalities out of which 5,090 are local. In Kakuma, the IRC directly implements HIV interventions at Kakuma Refugee camp serving mostly the refugee population while implementing HIV activities for the host population through partnership with Kakuma Mission Hospital.

TBD will support a package of services that includes clinical evaluation and laboratory monitoring, provision of cotrimoxazole prophylaxis, treatment of opportunistic infections, nutritional support and improved access to safe drinking water and malaria prevention interventions; 10 health treatment workers will also be trained to provide palliative treatment services using national guidelines. This will include training in diagnostic counseling and testing to improve/increase provider-initiated testing and subsequently increase patient enrolment into HIV treatment.

TBD will ensure that gender issues, referral and linkages between facility and community based services, monitor and evaluate clinical outcomes.TBD will also ensure that they work within strategies that are evidence based and cost efficient in delivery of treatment services.

TBD will expand treatment programs by providing technical support, supporting staff salaries, training staff, conducting laboratory evaluation.TBD will offer both facility and community based support activities to PLHIV to HIV counseling and testing , adherence to ART, psychosocial support , positive living and stigma reduction. The outcomes of these activities will be monitored and evaluated.

The main purpose under this TBD is to reduce the morbidity and mortality of refugees and immigrants in Kenya. The selected TBD partner will:

Support the implementation of Facility Based and Community Based HIV Testing and Counseling services among the refugees and migratory populations in Kenya.

Work to establish and strengthen linkage to other ongoing HIV prevention, care and treatment services for all individuals receiving HIV counseling and testing services.

Support provision of HTC services as part of the comprehensive package of comprehensive package of prevention services to populations at increased risk of HIV including CSWs, out of school youth, miraa traders/users, and migratory merchants within the refugee populations.

Establish community outreach campaigns that promote knowledge of HIV status and provide education for other health seeking behaviors - specifically for those refugees identified for resettlement to the United States of America and linkage to programs once in the United States.

The HVCT funding of this TBD will reach provide HTC services to 20,000 individuals including out-of school youth and will support the training of 100 providers on HTC service delivery. The TBD partner will be required to implement rigorous monitoring and evaluation of the project that will be used for reviewing and adjusting program activities based on monitoring information obtained.

TBD partner will support care and support services for 100 HIV-infected children at Dadaab and Kakuma refugee camp in North Eastern and Rift valley Province, Kenya and will target both refugees and the local population who access care in the refugee based clinics. This TBD represents a follow-on for care and support activities (PDCS) currently provided by International Rescue committee and UNHCR.

Dadaab, which was established in 1991, consists of three settlements (Ifo, Hagadera and Dagahare), and hosts 140,000 Somali refugees and 20,000 Kenyan Somalis. Each camp has a hospital and three satellite health centers. Sentinel surveillance activities in 2005 reported a 1.4% HIV sero-prevalence among ANC clinic attendees, and 1.7% among STI patients, indicating a generalized epidemic and providing an estimate of 2,300 HIV-infected refugees. Kakuma Refugee hosts 55,995 refugees of nine different nationalities out of which 5,090 are local. In Kakuma, the IRC directly implements HIV interventions at Kakuma Refugee camp serving mostly the refugee population while implementing HIV activities for the host population through partnership with Kakuma Mission Hospital.

TBD will support activities that provide drugs, food and commodities, supervision, improved quality of care and strengthening of health services, promote integration of routine care, nutrition services into maternal health services, strengthen laboratory and diagnostics for pediatric patients.TBD will support a package of services that includes clinical evaluation and laboratory monitoring and provision of care and support services. Training related to care and support services will be provided for 10 health care workers using national guidelines. This will include about adult antiretroviral care and support (ART) that will subsequently increase patient enrolment into HIV care and support.

TBD will expand care programs by providing technical support, training staff, supporting staff salaries, conducting laboratory evaluation, and providing adherence counseling and monitoring.

TBD partner will support treatment services for 50 HIV-infected children (including 20 new patients resulting in a 60 ever) at Dadaab and Kakuma refugee camp in North Eastern and Rift valley Province, Kenya and will target both refugees and the local population who access care in the refugee based clinics. This TBD represents a follow-on for treatment activities (PDTX) currently provided by International Rescue committee and UNHCR.

Dadaab, which was established in 1991, consists of three settlements (Ifo, Hagadera and Dagahare), and hosts 140,000 Somali refugees and 20,000 Kenyan Somalis. Each camp has a hospital and three satellite health centers. Sentinel surveillance activities in 2005 reported a 1.4% HIV sero-prevalence among ANC clinic attendees, and 1.7% among STI patients, indicating a generalized epidemic and providing an estimate of 2,300 HIV-infected refugees. Kakuma Refugee hosts 55,995 refugees of nine different nationalities out of which 5,090 are local. In Kakuma, the IRC directly implements HIV interventions at Kakuma Refugee camp serving mostly the refugee population while implementing HIV activities for the host population through partnership with Kakuma Mission Hospital.

TBD will support activities that provide drugs, food and commodities, supervision, improved quality of care and strengthening of health services, promote integration of routine care, nutrition services into maternal health services, strengthen laboratory and diagnostics for pediatric patients. TBD will support a package of services that includes clinical evaluation and laboratory monitoring and provision of treatment services. Training related to treatment services will be provided for 10 health care workers using national guidelines. This will include about adult antiretroviral treatment (ART) that will subsequently increase patient enrolment into HIV treatment.

TBD will expand care programs by providing technical support, training staff, supporting staff salaries, conducting laboratory evaluation, and providing adherence counseling and monitoring.

The main purpose under this TBD is to reduce the morbidity and mortality of refugees and immigrants in Kenya.

The HVAB funding of this TBD will reach 17,215 in-school-youth with programs to delay the initiation of sex. The TBD partner will be required to implement rigorous monitoring and evaluation of the project that will be used for reviewing and adjusting program activities based on monitoring information obtained.

The main purpose under this TBD is to reduce the morbidity and mortality of refugees and immigrants in Kenya. The selected TBD partner will strengthen and scale up prevention, care and treatment among HIV positive refugees and migratory populations in Kenya, including urban refugees. The partner will provide a comprehensive package of prevention services to populations at increased risk of HIV including CSWs, out of school youth, miraa traders/users, and migratory merchants within the refugee populations. The TBD partner will also provide other combination prevention services (including STI screening and treatment in addition to ART) and provide care and treatment services for this marginalized and highly migratory population. Further, the TBD partner will establish community outreach campaigns that promote knowledge of HIV status and provide education for other health seeking behaviors. These programs are specifically for those refugees identified for resettlement to the United States of America and linkage to programs once in the United States.

The HVOP funding of TBD will reach 14,291 adults with programs encouraging condom use, partner reduction, and elimination of concurrent partners, and will reach 4,764 youth with programs encuoraging return to abstinence, partner reduction, and increases condom use. The TBD partner will be required to implement rigorous monitoring and evaluation of the project that will be used for reviewing and adjusting program activities based on monitoring information obtained.

TBD partner will support PMTCT services for 200 HIV-infected individuals at Dadaab and Kakuma refugee camps in North Eastern and Rift Valley Province, Kenya and will target both refugees and the local population who access care in the refugee based clinics. This TBD represents a follow-on for PMTCT activities (PMTCT) currently provided by International Rescue Committee and UNHCR.

Dadaab, which was established in 1991, consists of three settlements (Ifo, Hagadera and Dagahare), and hosts 140,000 Somali refugees and 20,000 Kenyan Somalis. Each camp has a hospital and three satellite health centers. Sentinel surveillance activities in 2005 reported a 1.4% HIV sero-prevalence among ANC clinic attendees, and 1.7% among STI patients, indicating a generalized epidemic and providing an estimate of 2,300 HIV-infected refugees.

Kakuma Refugee hosts 55,995 refugees of nine different nationalities out of which 5,090 are local. In Kakuma, the IRC directly implements HIV interventions at Kakuma Refugee camp serving mostly the refugee population while implementing HIV activities for the host population through partnership with Kakuma Mission Hospital.

TBD will support activities that promote integration of PMTCT with routine maternal child health/reproductive health services, adult and child care and treatment. TBD will identify and/or create linkages with food and nutrition services while ensuring that all activities are carried out in a cost efficient and sustainable manner.

TBD will support a package of services that includes routine HIV testing and counseling, ARV prophylaxis and treatment for eligible women, inclusion of HIV specific information on mother and child health cards, essential care for women and children identified in the PMTCT programs, infant feeding and nutritional support.

TBD partner will support TB/HIV services for 100 HIV-infected adults and children individuals at Dadaab and Kakuma refugee camps in North Eastern and Rift Valley Province, Kenya and will target both refugees and the local population who access care in the refugee based clinics. This TBD represents a follow-on for TB/HIV activities (HVTB) currently provided by International Rescue Committee and UNHCR.

Sentinel surveillance activities in 2005 reported a 1.4% HIV sero-prevalence among ANC clinic attendees, and 1.7% among STI patients, indicating a generalized epidemic and providing an estimate of 2,300 HIV-infected refugees.

Dadaab, which was established in 1991, consists of three settlements (Ifo, Hagadera and Dagahare), and hosts 140,000 Somali refugees and 20,000 Kenyan Somalis. Each camp has a hospital and three satellite health centers.

Kakuma Refugee hosts 55,995 refugees of nine different nationalities out of which 5,090 are local. In Kakuma, the IRC directly implements HIV interventions at Kakuma Refugee camp serving mostly the refugee population while implementing HIV activities for the host population through partnership with Kakuma Mission Hospital.

TBD will support a package of services at the facility and community including TB screening of HIV patients and HIV testing for TB patients, clinical monitoring, related laboratory services, treatment and prevention of Tuberculosis, infection control.

TBD will refer TB/HIV patients for clinical care appropriately while ensuring that activities are implemented according to the national guidelines. TBD will collaborate with the Division of Leprosy Tuberculosis, and Lung Diseases (DLTLD) and other partners to achieve the national and PEPFAR goals. TBD will train 30 workers to offer TB/HIV activities to both adults and children.

TBD will monitor and evaluate the TB/HIV activities following the national guidelines and M&E framework.